Rapid COVID-19 Diagnosis Using Deep Learning of the Computerized Tomography Scans

1. Presented by Amir Mosavi
Rapid COVID-19 Diagnosis Using Deep Learning of
the Computerized Tomography Scans

2. The advantages and disadvantages of mentioned machine leaning
Models Advantages Disadvantages
Single models
SVM
Effective performance in high
dimensional spaces
Doesn't perform well with large data set
(required high trainingtime)
NB
Easy and fast class prediction in test
datasets
Need to calculate the
prior
probability
MLP
Adaptive learning, coefficients can
easily beadapted
It requires much more training data than
traditional
machine learning algorithms
CNN
Automatically detects
the important features
(Feature
Extraction), uses convolution of
image and filters to generate
invariant features
Unexplained functioning
of the network (Black box),
require
processors with parallel processing power
Ensemble models
AdaBoost
Less susceptible
to the overfitting problem than most
learning algorithms
Using too weak classifiers can lead to low
margins and overfitting
GBDT
Lots of
flexibility (can optimize
on
different loss
functions)
Too much
improvement to minimize all errors can
overemphasize outliers and cause
overfitting

3. PERFORMANCE COMPARISON BETWEEN COVID- 19 DETECTION
MODELS
Model
Artificial Neural Network Machine learning Ensemble learning
MLP CNN SVM NB AdaBoost GBDT
Accuracy 0.9400 0.9760 0.9920 0.9400 0.9600 0.9520
Precision 0.9895 0.9724 0.9819 0.9122 0.9459 0.9145
Recall 0.8715 0.9724 1.000 0.9541 0.9633 0.9816
F1-score 0.9268 0.9724 0.990 0.9327 0.9545 0.9469
MCC 0.8814 0.9512 0.9838 0.8793 0.9189 0.9050

4. Rapid COVID-19 Diagnosis Using Deep Learning
of the Computerized Tomography Scans
Hamed Tabrizchi
Department of Computer Science,
Shahid Bahonar University of Kerman
Kerman, Iran
0000-0001-9250-2232
Imre Felde
John von Neumann Faculty of
Infromatics, Obuda University
Budapest, Hungary
felde@uni-obuda.hu
Amir Mosavi *
School of Economics and Business
Norwegian University of Life Sciences
1430 Ås, Norway
amir.mosavi@kvk.uni-obuda.hu
Laszlo Nadai
Kalman Kando Faculty of Electrical
Engineering, Obuda University
Budapest, Hungary
nadia@uni-obuda.hu
Akos Szabo-Gali
John von Neumann Faculty of
Infromatics, Obuda University
Budapest, Hungary
szabogaliakos@stud.uni-obuda.hu
Abstract— Several studies suggest that COVID-19 may be
accompanied by symptoms such as a dry cough, muscle aches,
sore throat, and mild to moderate respiratory illness. The
symptoms of this disease indicate the fact that COVID-19 causes
noticeable negative effects on the lungs. Therefore, considering
the health status of the lungs using X-rays and CT scans of the
chest can significantly help diagnose COVID-19 infection. Due
to the fact that most of the methods that have been proposed to
COVID-19 diagnose deal with the lengthy testing time and also
might give more false positive and false negative results, this
paper aims to review and implement artificial intelligence (AI)
image-based diagnosis methods in order to detect coronavirus
infection with zero or near to zero false positives and false
negatives rates. Besides the already existing AI image-based
medical diagnosis method for the other well-known disease, this
study aims on finding the most accurate COVID-19 detection
method among AI methods such as machine learning (ML) and
artificial neural network (ANN), ensemble learning (EL)
methods.
Keywords— COVID-19, image-based diagnosis, artificial
intelligence, machine learning, deep learning, computerized
tomography, coronavirus disease,
I. INTRODUCTION
COVID-19 is a global pandemic that collapsed the
healthcare systems in most countries. In the year 2020, people
all over the world witnessed the news of the death of their
fellow human beings from many world news agencies.
Furthermore, this pandemic event has affected the operations
of healthcare facilities. The medical centres witnessed
increases in patients who are needing care for a respiratory
illness that could be COVID-19 (+) or COVID-19 (-). The
World Health Organization (WHO) advises that all countries
to consider the importance of the test because the isolation of
all confirmed cases and also mild cases in health centers is
able to prevent transmission and provide acceptable care. One
of the pivotal reasons for the need to use intelligent systems in
the process of diagnosing this disease (taste) is the easy
transmission of this disease among people in a community or
even health facilities [1,2]. Since most of the excited test
needs a lot of time to generate the result compared to the time
for spreading virus among people, chest X-Ray or Computer
Tomography (CT) scan images of COVID19 is used to
provide a rapid and efficient way to test the COVID-19
suspected individuals. It is an undeniable fact that artificial
intelligence plays a central role in making human daily life
more convenient than the past. The advantage of AI methods
is their ability to interpret and understand the digital images in
order to identify and classify objects. For this reason, many
researchers in the world of artificial intelligence have drawn
attention to research on the data obtained from patients who
infected with COVID-19. Sachin Sharma [3] presents a study
that aims to discuss the importance of machine learning
methods to distinguish COVID-19 infected regarding their
lung CT scan images. Nripendra Narayan Das et al. [4] use
chest X-rays in order to find some radiological signatures of
COVID-19 by using deep learning of the chest CT scans.
Aayush Jaiswal et al. [5] use the pre-trained deep learning
architectures (DenseNet201) along with deep transfer learning
in order to provide an automated tool that aims to detect
COVID-19 positive and negative infected patients based on
chest CT images. Xueyan Mei et al. [6] combine chest CT
records including the patients’ essential symptoms. In this
pioneer research the interaction between the chest CT and the
clinical symptoms is conducted through basic machine
learning methods, i.e., SVM, random forest, MLP, and deep
learning to accurately predict COVID-19. In an alternative
approach, Pinter et al. [7] present the hybrid machine learning
method of ANFIS and MLP to predict mortality rate of
COVID-19 patients. Sina F. Ardabili et al. [8] review a wide
range of machine learning models to forecast the COVID-19
outbreak. Their study presents a number of suggestions to
demonstrate the potential of machine learning for future
research.

5. In a nutshell, the main motivation of this paper is to find
the most accurate intelligent approach for detecting COVID-
19. In other words, we use state-of-the-art learning models in
order to classify positive and negative COVID-19 suspected
individuals with regard to their captured chest X-Ray or CT
scan images.
The rest of this paper is outlined as follows. Section 2
reviews Machine leaning-based models. Section 3 compares
the performances of the described and implemented machine
learning models. Finally, Section 4 draws conclusions and
offers some suggestions for the end-users of medical
intelligent systems.
II. BRIEF REVIEW OF MACHINE LEANING-BASED MODELS
AI has the potential to improve medical imaging
capabilities and patient diagnosis. Using ML, ANN, and
ensemble learning methods for medical image recognition is
a core component of computer vision in this widespread study
area. ML methodology works based on the cognitive learning
methods to advance an intelligent code without use of
conventional programing techniques. The performance of
ML algorithms’ is associated with other mathematical
techniques and improved by experience [4]. Generally, ML
uses historical data to make decisions and uncover hidden
insights [5]. In image-based diagnosis problems, the ML
models are advanced to be able to learn from medical records.
This process is often done through developing insight into the
patterns within complex imaging [6]. The following
subsection describes the basic and ensemble AI-based image
classifier methods in a brief way.
A. Singlemodels
In the following, the basic classifiers employed for
diagnosing COVID-19 are introduced.
 Support Vector Machine (SVM) is one of the commonly-
used algorithms in research and industry, taking its power
from machine learning algorithms. The main advantage
of this algorithm is its ability to deal with non-linear
problems. SVM can be used to solve nonlinear
classification problems by transforming the problem
using the kernel method which makes SVM calculation in
the higher dimension. Vapnik was first introduced SVM
in 1995[]. He used the Statistic Learning Theory (SLT)
and Structural Risk Minimization (SRM) to introduce this
concept. SVM can be effectively employed in
classification, regression, and nonlinear function
approximation problems [9,10].
 Naive Bayes (NB) is a well-known probabilistic
classification algorithm that applies Bayes' Theorem with
an assumption of strong (naive) independence among
predictors (a set of supervised learning algorithms).
During the process of constructing classifiers (training),
the NB model needs a small amount of training data to
estimate the vital parameters [11]. In other words, the
previous probability of each class is estimated by
calculating the conditional probability density function
and the posterior probability. Eventually, the final
prediction is made for the class that has the largest
posterior probability.
 Artificial neural networks (ANN) are computing systems
that widely used for image-based medical diagnosis
problems. In fact, ANN draws inspiration from biological
neural systems and creates an interconnected network of
‘neurons that process information. These models consist
of several processing elements that reproduce input data
in a hierarchical structure. During the training process, a
corresponding weight (for each input data) must be
iteratively estimated and adjusted. Due to the variation of
connections between layers in an ANN, the architecture
of networks is able to design variously. Deciding the
number of layers and nodes in each layer depends on the
problem and the amount of training data. For this reason,
ANN is a great (flexible) option to deal with different
classification, regression, and clustering problems
[12,13].
 Multilayer perceptron (MLP) is a well-known ANN in
which neurons are distributed in thoroughly connected
layers. These layers are divided into three groups: input
layers, output layers, and hidden layers. The weighted
inputs are linearly combined by their corresponding
neuron; then, the results are transferred through a
nonlinear activation function. Usually, a gradient-descent
algorithm called back-propagation is used to train an
MLP. In this algorithm, a maximum error is defined to be
used as a criterion to stop the iterative weight update
process [14].
 CNN is a deep neural network that is commonly applied to
process large scale images. As same as the other ANN,
CNN is a network that includes several layers. In CNN
represents a sequential connection between the layers. As
the output of the previous layer is interconnected with the
input of other layer. However, unlike the other fully
connected neural network, in this network, the neurons in
one layer do not connect to all the neurons in the next
layer. The main powerful part of CNN is the convolution
layer [15,16].
B. Ensemblemodels
Ensemble models are able to scale up the performance of
classification and regression processes. Boosting and Bagging
are the most widely-used ensemble learning frameworks in
science literature. Bagging ensembles create subsets and
ensemble estimates using Bootstrap re-sampling and a mean
combiner respectively. Boosting ensemble models train a
number of individual models in a sequential way. A way that
provides an opportunity for each model to learns from
mistakes made by the previous model [17].
 AdaBoost (Adaptive Boosting) is an ensemble learning
algorithm that can be used in conjunction with many other
types of learning algorithms to improve performance.
AdaBoost initially created to enhance the performance of
binary classifiers. The main idea of AdaBoost is about
using an iterative approach in order to learn from the
mistakes of weak classifiers, and turn them into strong
ones. In fact, AdaBoost learns from the mistakes by
increasing the weight of misclassified data points [18].
 Gradient boosting decision tree (GBDT) is an ML
algorithm, which produces a prediction model in the form
of an ensemble of weak prediction models (decision
trees). Gradient Boosting learns from the residual error
(directly), rather than update the weights of data points
[19].

6. In a nutshell, Table I indicates the advantages and
disadvantages of all mentioned machine leaning models.
TABLE I. ADVANTAGES AND DISADVANTAGES OF ML MODELS
Models Advantages Disadvantages
Single models
SVM
Effective
performance in
high
dimensional
spaces
Doesn't perform
well with large data
set (required high
trainingtime)
NB
Easy and fast
class prediction
in test datasets
Need to calculate
the prior
probability
MLP
Adaptive
learning,
coefficients can
easily beadapted
It requires much
more training data
than traditional
machine learning
algorithms
CNN
Automatically
detects the
important
features (Feature
Extraction), uses
convolution of
image and filters
to generate
invariant
features
Unexplained
functioning of
the network (Black
box), require
processors with
parallel processing
power
Ensemble
models
AdaBoost
Less susceptible
to the overfitting
problem than
most learning
algorithms
Using too weak
classifiers can lead
to low margins and
overfitting
GBDT
Lots of
flexibility (can
optimize on
different loss
functions)
Too much
improvement to
minimize all errors
can overemphasize
outliers and cause
overfitting
III. EXPERIMENTALRESULTS
In this section, all described models in the previous section
were evaluated and examined based on the datasets that
include image data on 980 patients suspected with COVID-19
infection. The implementation is facilitated under Python
using Scikit-Learn and Keras libraries. The experimental
results are provided and analyzed in detail by using a standard
CPU with the information of Intel Core i5-2.20 GHz with 16
GB RAM.
A. Data description
This paper evaluates all described models mentioned in the
previous section based on two datasets. The first data set
includes image data on 430 patients infected with COVID-19.
Also, 550 healthy (normal) individuals were randomly
selected from the second data set [20]. The following Figure
illustrates sample images of both classes.
B. Performance evaluation
In the presented study, we split the data images into a
training and testing image set. We use 75% of the data as the
training data for training the model, the next 25% remaining
data were used as testing data. Moreover, all considered
models were evaluated by taking advantage of the well-known
performance criteria and Matthews correlation coefficient
(MCC) [21,22].
Fig. 1. X-ray images of normal and COVID-19 caused patient
According to the confusion matrix, the formulas for these
measurements are described briefly as follows.
Accuracy = TP+TN
TP+FN+FP+TN
(1)
Precision = TP
T P+FP
(2)
Recall = T P
T P+FN
(3)
F1 − score = 2×P×R
P+R
(4)
MCC = T P×T N–FP×FN
ƒ( T P+FP)(T P+FN)(T N+FP)(T N+FN)
(5)
where FN and Fp present the quantity of the incorrect
predictions respectively. TP and TN indicate the quantity of
correct predictions.
The results of the implemented machine learning
algorithms evaluated using the datasets described earlier.
Table. II presents the performance of trained models with
regard to the mentioned standard performance criteria.

7. TABLE II. PERFORMANCE COMPARISON BETWEEN COVID-
19 DETECTIONMODELS
Model
Artificial Neural
Network
Machine learning Ensemble learning
MLP CNN SVM NB AdaBoost GBDT
Accuracy 0.9400 0.9760 0.9920 0.9400 0.9600 0.9520
Precision 0.9895 0.9724 0.9819 0.9122 0.9459 0.9145
Recall 0.8715 0.9724 1.000 0.9541 0.9633 0.9816
F1-score 0.9268 0.9724 0.990 0.9327 0.9545 0.9469
MCC 0.8814 0.9512 0.9838 0.8793 0.9189 0.9050
In our experiment, each test set is executed with six
different machine learning algorithms. By using the values in
the confusion matrix, 5 different statistics (in Equations. (1–
5)) are calculated to measure the efficiency of the algorithms.
In this study, the architecture of MLP designed as five fully
connected layers with 350, 250,150,50 and 2 number of
neurons in each layer, respectively. Except for the last layer,
the rectified linear unit (Relu) used in considered MLP
network and the last layer use "softmax" activation, which
means it will return an array of 2 probability scores (Positive
or Negative).
In addition, the architecture of CNN designed as four
convolution layers with a convolution kernel size of 7x7 to
extract the features and each them uses 3x3 average pooling
layer or max pooling to prevent the features. The number of
convolution in each convolution layer is at least 64. After the
max pooling layer, two 512-dimensional fully connected
layer are added, along with dropout layer in order to prevent
overfitting problem. In Table II, the results show that SVM
outperforms the other models. The Table includes the
performance of CNN which has provided a 97% accuracy
rate. In addition, it is reported an 99% accuracy for the SVM
model. Sine image-based diagnosis SVM model has to deal
with nonlinear pattern of data, we considered RBF kernel for
SVM. Furthermore, the confusion matrix for the considered
learning models is constructed in Table III.
Table. III. CONFUSION MATRIX
Model Confusion matrix
Predicted
P N
MLP Actual
P 140 1
N 14 95
CNN Actual
P 138 3
N 3 106
SVM Actual
P 139 2
N 0 109
NB Actual
P 131 10
N 5 104
AdaBoost Actual
P 131 10
N 2 107
GBDT Actual
P 135 6
N 4 105
IV. CONCLUSIONS
Rapid diagnosis of COVID-19 symptoms is of utmost
importance. This paper implemented COVID-19 detection
models by using six different machine learning algorithms, as
SVM, NB, GBDT, AdaBoost, CNN and MLP based on the
datasets that include image data on 980 patients suspected
with COVID-19 infection. The main purpose of this study was
to introducing image-based ML methods for developers and
end-users of intelligent medical systems in a comprehensive
way. We compared the performance of the state-of-the-art
models to show that how important is the ML image-based
models reliability to diagnose diseases. The experimental
results and discussions proved that the SVM with RBF kernel
outperforms other existing methods.
ACRONYMS
AI
ANN
CT
CNN
EL
GBDT
ML
MCC
MLP
NB
SLT
SRM
SVM
WHO
Artificial intelligence
Artificial neural
networks
Computer Tomography
Convolutional neural
networks
Ensemble learning
Gradient boosting
decision tree
Machine learning
Matthews correlation
coefficient
Multilayer perceptron
Naive Bayes
Statistic Learning Theory
Structural Risk
Minimization
Support Vector Machine
World Health
Organization
ACKNOWLEDGMENT
We acknowledge the financial support of this work by the
Hungarian State and the European Union under the EFOP-
3.6.1-16-2016-00010 project and the 2017-1.3.1-VKE-2017-
00025 project. The research presented in this paper was
carried out as part of the EFOP-3.6.2-16-2017-00016 project
in the framework of the New Szechenyi Plan. The completion
of this project is funded by the European Union and co-
financed by the European Social Fund. We acknowledge the
financial support of this work by the Hungarian State and the
European Union under the EFOP-3.6.1-16-2016-00010
project. We acknowledge the financial support of this work
by the Hungarian-Mexican bilateral Scientific and
Technological (2019-2.1.11-TÉT-2019-00007) project. The
support of the Alexander von Humboldt Foundation is
acknowledged.
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